Fear of widespread outbreak as Ebola spreads to city

Cases of Ebola have been reported in a city of several hundred thousand inhabitants in Democratic Republic of Congo (DRC), prompting fears that the outbreak will spread out of control in this densely populated urban area.

An outbreak of the deadly haemorrhagic disease was first reportedon May 8 in the rural area of Bikoro in the north west of the country and the latest figures now show that 42 people have now been infected.

But health experts are worried about reports of three cases - one of which has been laboratory confirmed by DRC’s ministry of health - in the city of Mbandaka, next to the Bikoro area.

Mbandaka is on the river Congo, which in a country with few good roads, acts as the “highway of central Congo”, said Jose Barahona, country director in DRC for UK charity Oxfam.

“Boats move up and down the river, people and goods travel. One of the risks is that someone with the virus could easily access one of the boats and start moving up and down,” he said.

The capital of DRC, Kinshasa, is also on the river as is Brazzaville, the capital of neighbouring Congo-Brazzaville.

The authorities always feared the spread of the disease to the city, which is just 130km away from Bikoro, and Barahona said it was what “kept him awake at night”.

“If the number increases in Bikoro it’s bad but it’s not a disaster but if these three cases in Mbandaka become 10 or 12 then we have an urban epidemic,” he said.

Some 514 people who may have been in contact with infected people have been notified by the national health authorities and are being monitored.

Henry Gray, Médecins Sans Frontières (MSF) emergency coordinator in DRC, said with the spread of the disease to the city the situation had become “most serious and worrying”. He said one case in the city had been confirmed.

“It is paramount to trace the suspect case in order to have a clearer view on how it reached the city. We are working closely with the ministry of health and the other organisations in the field to implement a coordinated, tailored and rapid response to stop the spread of Ebola,” he said.

MSF teams have set up an isolation zone in the city’s main hospital and are building two Ebola treatment centres with 20 beds each in Mbandaka and Bikoro.

The first 4000 batches of the VSV Ebola vaccine have arrived in the country and the World Health Organization, in partnership with MSF and the Congolese ministry of health will soon start a ring vaccination programme - where contacts around an infected individual are vaccinated.

This is an experimental vaccine which has only been approved for emergency use, said John Edmunds, professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine, who led the original studies into the vaccine.

He said that because the vaccine is not yet licensed introducing a campaign was not straightforward.

“Officially it has to be part of some sort of research study because it’s not a licensed vaccine but there is a work-around so you can use it under special circumstances. They won’t be randomising people - everyone who needs it will get it,” he said.

The vaccine has to be kept between minus 60 and minus 80 degrees celsius, which will be a complex operation in a country with poor infrastructure.

“It’s a big headache to deliver the vaccine and keep it frozen. It is a major operation to get the cold chain up and running and to get it right out into the field,” he said.

This is the ninth outbreak of the disease in DRC since Ebola was first discovered in what was then known as Zaire in 1976.

The Congolese authorities are used to controlling the disease but previous outbreaks have taken place in remote areas, said Barahona.

“In 2014 there was another outbreak in the same province but it was inland and in a place that was difficult to access by road and there was no access by the Congo river,” he said.

Captain Camille-Aimé Coquilhat (1853–1891) was a Belgian soldier, explorer and colonial civil servant who finished his career as Vice Governor-General of the Congo Free State from 1890 until his death in 1891. He was notably an associate of Henry Morton Stanley during his expeditions in the Haut-Congo

A Belgian at the bottom again

Originally Posted by HuangLaoThose with lesser cognitive reasoning should refrain from commentary.